Sensibility and understandability
Eleven raters provided feedback on the sensibility and understandability of the GRADE system for grading evidence and formulating recommendations. Nine of the 11 respondents agreed or strongly agreed that the judgements about the overall quality of evidence were clear and understandable, and that the judgements about the balance between benefits and harms were clear and understandable using the GRADE approach. Everyone agreed or strongly agreed that the judgements about recommendations were clear and understandable. Eight of the judges agreed or strongly agreed that the GRADE approach to judging the overall quality of evidence was better than other grading systems with which they were familiar. Two disagreed and one was not sure. Eight also agreed that the GRADE approach to formulating recommendations was better than approaches with which the raters were familiar. Three raters were not sure about whether the GRADE approach was superior to other approaches of formulating recomendations.
Nine of the 11 respondents agreed or strongly agreed that the GRADE approach was applicable to different types of interventions, and that the approach was clear and simple to apply. Five judges disagreed that the information that is needed is generally available, two were not sure and four agreed. Six of the eleven judges disagreed or strongly disagreed that subjective decisions were generally not needed, four were not sure and one agreed. Ten of the eleven judges agreed or strongly agreed that all the components included in each of the four types of judgements should be included; one judge was not sure. Five of the judges were unsure if there were not important components that were missing from any of the four types of judgements, one disagreed and three agreed or strongly agreed. Eight judges agreed or strongly agreed that the ways in which the components were aggregated for each of the four types of judgements were clear and simple; three were unsure. Seven judges agreed or strongly agreed that the ways in which the included components were aggregated were appropriate for each of the four types of judgements, two were unsure and two disagree. Ten of the eleven judges agreed or strongly agreed that the categories were sufficient to discriminate between different grades for each of the four types of judgements; one disagreed. All the eleven judges agreed or strongly agreed that the GRADE approach successfully discriminated between different quality of evidence, and between different grades of recommendations.